Pattern of Referrals to Psychiatrist in a Multi-specialty Tertiary Hospital in Nigeria: A Retrospective Study

ABSTRACT Background: Referral pattern to psychiatric services is inadequately documented in Nigerian tertiary hospitals. Consultation-liaison psychiatry (CLP) plays a crucial role in integrating mental health care in tertiary care hospitals. Objective: To assess the pattern of referrals to a psychiatry department from other specialties in a Nigerian teaching hospital. Methodology: This cross-sectional retrospective study examined the referral patterns to the psychiatry department at Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria, over a two-year period (June 2nd, 2022 - June 5th, 2024). Data from 263 in-hospital referrals were analysed using SPSS version 23. Information obtained included referring department, sub-specialty involved, reasons for seeking psychiatric consultation and psychiatric diagnosis. Results: The study revealed that nearly half (46.8%) of referrals were from Internal Medicine and Surgery (27.4%), with frequent requests originating from Neuro-surgery and Cardiology sub-specialties. The majority of referrals were prompted by irrelevant speech (35.7%) or disturbing behaviours such as restlessness (24.0%) and aggression (17.9%). Schizophrenia/psychosis and major depression were the most commonly diagnosed conditions. Notably, 57.0% of referrals did not specify a psychiatric diagnosis. Conclusion: There is a potential under-utilization of CLP from other specialties, and challenging behaviours was the major reason that prompts psychiatry consultation. This underscores a critical necessity for increased awareness of other psychiatric signs and symptoms, and integration of psychiatric services throughout all medico-surgical subspecialties.